A nurse is visiting a client who has Alzheimer's disease in their home. The client's spouse states that the client gets increasingly agitated and restless in the evening hours and can sometimes be difficult to calm down. Which of the following behaviors does the nurse recognize that the client is experiencing?

Relocation stress syndrome

Wandering

Sundowning

Depression

Answer and Explanation

The Correct Answer is C

A. Relocation stress syndrome: Relocation stress syndrome refers to the physical and psychological symptoms experienced by individuals when they are moved from one environment to another, such as transitioning to a new residence or healthcare facility. While relocation stress syndrome can cause agitation and confusion in individuals with Alzheimer's disease, the scenario provided does not indicate a recent relocation.

B. Wandering: Wandering is a common behavior observed in individuals with dementia, where they aimlessly roam or wander in their environment. While wandering may be associated with agitation and restlessness, the scenario does not describe the client physically moving around or attempting to leave their home.

C. Sundowning: Sundowning refers to a phenomenon commonly observed in individuals with Alzheimer's disease or other forms of dementia, where they experience increased agitation, confusion, and restlessness in the late afternoon or early evening hours. Sundowning behaviors can include pacing, agitation, anxiety, irritability, confusion, and difficulty sleeping. The exact cause of sundowning is not fully understood but may be related to factors such as fatigue, sensory overload, hormonal imbalances, or disruptions in the sleep-wake cycle. Managing sundowning behaviors often involves creating a calming environment, maintaining a consistent daily routine, minimizing stimuli in the evening, and providing reassurance and comfort to the individual.

D. Depression: Depression can occur in individuals with Alzheimer's disease and may present with symptoms such as sadness, hopelessness, loss of interest in activities, changes in appetite or sleep patterns, and difficulty concentrating. However, the scenario primarily describes agitation and restlessness in the evening hours, which is characteristic of sundowning rather than depression.

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Correct Answer is D

Explanation

A. Creatine kinase (CK) test: While creatine kinase isoenzymes, including CK-MB, can be elevated following myocardial infarction (MI), they are not specific to cardiac muscle injury. CK is found in various tissues throughout the body, so elevated levels can also indicate damage to skeletal muscle or brain tissue, among other sources.

B. Creatine kinase-myocardial band (CK-MB) test: CK-MB is a cardiac-specific isoform of creatine kinase, and elevated levels can indicate myocardial injury, particularly in the context of an acute MI. However, troponin T is a more sensitive and specific marker for myocardial injury.

C. Brain natriuretic peptide (BNP) test: Brain natriuretic peptide is primarily used in the diagnosis and management of heart failure. While elevated BNP levels can indicate heart muscle strain or stress, they are not specific markers for acute myocardial infarction or early injury to the cardiac muscle.

D. Troponin T test: This is the correct answer. Troponin T is a highly specific marker for cardiac muscle injury. Elevated troponin levels can be detected within hours of myocardial infarction and persist for several days, making it an essential tool in the diagnosis of acute coronary syndromes, including myocardial infarction. Troponin T is considered one of the gold standard biomarkers for detecting early injury to the cardiac muscle.

A. Hypoxia and acidosis B. Hearing deficits and increased risk of glaucoma C. Bipolar behaviors and schizotypal behaviors D. Disorientation and depression

Correct Answer is D

Explanation

A) Hypoxia and acidosis While hypoxia and acidosis are serious complications of shock, they are physiological rather than psychological outcomes. These conditions primarily affect the body's metabolic and respiratory functions, rather than mental health or behavior.

B) Hearing deficits and increased risk of glaucoma Hearing deficits and increased risk of glaucoma are potential complications associated with certain medical conditions or medications but are not directly related to the psychological outcomes of shock. These conditions affect sensory perception (hearing and vision) rather than mental health or behavior.

C) Bipolar behaviors and schizotypal behaviors Bipolar behaviors and schizotypal behaviors are manifestations of mood and psychotic disorders, respectively, and are not typical adverse outcomes of shock. While psychological disturbances can occur in critically ill patients, they are not commonly characterized by specific psychiatric diagnoses like bipolar or schizotypal behaviors.

D) Disorientation and depression Disorientation and depression are common adverse psychological outcomes experienced by patients who have spent an extended period in the intensive care unit (ICU) due to complications related to shock. Prolonged ICU stays, medical interventions, sedation, and physical discomfort can contribute to feelings of confusion, disorientation, and depression in patients. Therefore, it is essential for the nurse to educate the client about these potential psychological effects and provide appropriate support and resources to address them during the transition to the medical unit.

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Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client who experienced a myocardial infarction prior to a cardiac arrest. Which of the following laboratory tests will identify early injury to the cardiac muscle?

Correct Answer is D

Explanation

A nurse is providing care to a client who has spent several weeks in the intensive care unit because of complications related to shock. What adverse psychological outcomes should the nurse educate the client about prior to transfer to the medical unit?

Correct Answer is D

Explanation

A nurse is developing a plan of care for a client who has Meniere’s disease. Which of the following medications should the nurse anticipate administering?

A nurse is educating the family of a client who has Alzheimer's disease. The nurse should be sure to communicate that which of the following behavioral manifestations can occur in clients with Alzheimer’s disease? (Select All that Apply.)

A nurse is planning care for a client who has hypertrophic cardiomyopathy that has not improved after pharmacologic treatment. Which of the following procedures should the nurse anticipate the health care provider ordering?

The spouse of an older client experiencing delirium is at the client's bedside. The nurse is providing an update to the spouse regarding the client's plan of care. Which of the following responses by the spouse indicates a need for further teaching?

A nurse and a newly licensed nurse are providing care for a client who has distributive shock. How should the nurse explain the pathophysiology of distributive shock to the newly licensed nurse?

A nurse is planning care for a client who has a traumatic brain injury (TBI). Which of the following nursing interventions should be added to the plan of care? (Select All that Apply.)

A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

A nurse is reinforcing teaching to a group of high school students about how penetrating traumatic brain injuries cause damage to the brain. Which of the following statements should the nurse include in the teaching?